The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Evaluation of frequency of antibodies against ciclic citrullinated peptide (aCCP) in sera of patients with rheumatoid factor test request.

A região do Distrito Mineiro de Ametista do Sul, situada no Estado do Rio Grande do Sul, destaca-se por ser uma importante fornecedora de ametista para o mercado nacional e internacional. O quartzo incolor (cristal de rocha) que ocorre associado à ametista, ainda que com pouco valor comercial, possui significativo potencial para obtenção da cor verde (prasiolita) a partir da exposição à irradiação gama. Para avaliar a potencialidade de geração de prasiolita do quartzo incolor proveniente dessa região, realizou-se inicialmente o cálculo do Fator Ametista por meio dos de espectros no infra-vermelho. Os valores de 1,13 a 1,68 indicam satisfatória disposição para a obtenção da cor verde posteriormente à exposição às doses de radiação de 900 kGy. As principais bandas de absorbância identificadas foram 3381 cm-1, 3433 cm-1, 3441 cm-1, 3585 cm-1 e 3595 cm-1, que se relacionam com as ligações AlSi-OH/Na+, FeSi-OH/H+ e Si-OH, descritas na literatura como relacionadas às causas de cor. A presença de água molecular nas amostras analisadas, apresentaram variações entre 0,09 a 0,18%. As doses de 200 e 900 kGy foram utilizadas para a irradiação das amostras de quartzo incolor, resultando na cor verde em diferentes tonalidades, verde muito claro, claro e escuro. No entanto, não foi observada uma relação direta entre as tonalidades de cor e as doses de irradiação aplicadas. Em determinadas amostras com seções mais fraturadas não houve acréscimo de cor, tornando-as verde incipiente ou persistindo o incolor. Porém para amostras mais límpidas, houve alteração para cor verde homogênea. O estudo não identificou proporcionalidade entre a dose de exposição à irradiação com a intensidade da cor, tampouco com a porcentagem de água molecular nas amostras.The Ametista do Sul Mining District, located in Rio Grande do Sul State (Brazil), is an important supplier of amethyst for the national and international market. Colorless quartz (rock crystal) that occurs in association with amethyst, which has a little commercial value, usually has a significant potential for obtaining green color (prasiolite) after exposure to gamma irradiation. In order to evaluate the potential for prasiolite generation from colorless quartz of this region, the Amethyst Factor was initially calculated using infrared spectra. Values from 1.13 to 1.68 indicate a satisfactory disposition to obtain the green color after exposure to radiation doses of 900 kGy. The main absorption bands Identified were 3381 cm-1, 3433 cm-1, 3441 cm-1, 3585 cm-1 and 3595 cm-1, which are linked to AlSi-OH/Na+, FeSi-OH/H+ and Si-OH bonds, described in literature as related to origin of color in quartz. Molecular water in the analyzed samples varied between 0.09 and 0.18%. The doses of 200 and 900 kGy were used for irradiation of colorless quartz samples, resulting in green color in different hues (very light, light and dark green). However, it was not observed a direct relationship between the color intensity and the applied irradiation doses. Some samples with several fractured sections, did not generate nice green color, turning to an incipiente green or persisting as colorless quartz. However, in clear samples, there was observed a color change to na homogeneous green color. The study did not identify a proportionality between irradiation exposure doses and the color intensity, and also with the percentage of molecular water in the samples

The clinical significance of coagulation and the inflammatory response in autoimmunity

Maintenance of normal blood flow requires equilibrium between procoagulant and anticoagulant factors; occasionally, procoagulant activity predominates, leading to clot formation; frequently, tissue damage is the triggering factor. Hereditary factors, primary or acquired, play a role in the development of thrombosis. Primary thrombophilia is associated with hereditary factors, which promote hypercoagulability because natural anticoagulants are not exerting their activity. On the other hand, acquired thrombophilia may occur associated to autoimmune diseases, cancer, surgical procedures, pregnancy, postpartum period, and obesity. Activation of the coagulation system is characterized by the co-participation of inflammatory response components, factors related to the subjacent disease, and other procoagulant factors. The study of patients with thrombosis should include both inflammatory and autoimmune response markers. � 2011 Springer Science+Business Media, LLC